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Santos LM, Amorim LDAF, Santos DN, Barreto ML. Measuring the level of social support using latent class analysis. SOCIAL SCIENCE RESEARCH 2015; 50:139-146. [PMID: 25592926 DOI: 10.1016/j.ssresearch.2014.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 11/12/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
Different instruments have been used to measure social support in epidemiological studies of which the most widely used is the Medical Outcomes Study Social Support Scale (SSS-MOS). However, these studies lack measures of the level of social support on health risks. We used latent class analysis (LCA) to distinguish subgroups with different levels of perceived social support and tested the consistency of these subgroups by their associations with the prevalence of Common Mental Disorders (CMD). This is a cross-sectional study of 1013 mothers living in the city of Salvador, Brazil in which psychosocial data were collected through home visits using the SSS-MOS and the Self Reporting Questionnaire-20. For each dimension of social support analysed here, we selected models with two classes using LCA. Multivariate logistic regression models were used to estimate the association between participants' perceived social support and the prevalence of CMD to verify the consistency of the groups defined by LCA. There was a clear difference in the reporting of perceived social support between those classified as high or low using LCA. The probability of perceiving several types of social support was lower in the subgroup classified as low level of social support (13.7-59.8%), and it was much higher in the group classified as high level of social support (84.3-98%). A greater prevalence of CMD was found among mothers with lower levels of social support. LCA seems to be a useful tool to improve measurement of perceived social support by separation into two levels in which the lower level is associated with an increased prevalence of CMD.
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Matos SMA, Jesus SR, Saldiva SRDM, Prado MS, D'Innocenzo S, Assis AMO, Rodrigues LC, Alcantara-Neves NM, Cruz ÁA, Simões SDM, Fiaccone RL, Barreto ML. Weight gain in the first two years of life, asthma and atopy: the SCAALA cohort study. Public Health Nutr 2014; 17:2537-45. [PMID: 24160321 PMCID: PMC10282202 DOI: 10.1017/s1368980013002899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/30/2013] [Accepted: 09/23/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the association between weight gain in the first two years of life and the occurrence of wheezing, asthma, serum IgE, skin reactivity and pulmonary function. DESIGN Cohort study. SETTING The metropolitan region of Salvador, Bahia, Brazil. SUBJECTS The association was studied between 1997 and 2005 in 669 children up to 11 years of age. Data were collected on asthma and risk factors, both current factors and those present in the first years of life. Weight gain was considered fast when the Z-score was >0·67. Poisson regression was used in the multivariate statistical analysis. RESULTS Wheezing was reported in 25·6 % of the children. Weight gain was considered fast (Z-score >0·67) in 29·6 % of the children and slow (Z-score <-0·67) in 13·9 %. Children in the slow weight gain group had 36 % fewer symptoms of asthma (prevalence ratio = 0·65; 95 % CI 0·42, 0·99). CONCLUSIONS Slower weight gain in the early years of life may constitute a protective factor against symptoms of asthma. The relevance of this finding for public health is not yet certain, since it is known that children with slow and fast weight gain may be more likely to develop adverse health consequences related to both these situations.
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Santos FCD, Brandão MDM, Silva CCD, Machado LS, Soares MV, Barreto ML, Nascimento ERD, Pereira VLA. Eggshell apex abnormalities in a free-range hen farm with mycoplasma synoviae and infectious bronchitis virus in Rio de Janeiro state, Brazil. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2014. [DOI: 10.1590/1516-635x1602101-104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Santos LN, Gallo MBC, Silva ES, Figueiredo CAV, Cooper PJ, Barreto ML, Loureiro S, Pontes-de-Carvalho LC, Alcantara-Neves NM. A proteomic approach to identify proteins from Trichuris trichiura extract with immunomodulatory effects. Parasite Immunol 2014; 35:188-93. [PMID: 23398517 DOI: 10.1111/pim.12025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 12/28/2012] [Indexed: 12/28/2022]
Abstract
Infections with Trichuris trichiura and other trichurid nematodes have been reported to display protective effects against atopy, allergic and autoimmune diseases. The aims of the present study were to investigate the immunomodulatory properties of T. trichiura adult worm extract (TtE) and its fractions (TtEFs) on the production of cytokines by peripheral blood mononuclear cells and to identify their proteinaceous components. Fourteen TtEFs were obtained by ion exchange chromatography and tested for effects on cytokine production by peripheral blood mononuclear cells. The molecular constituents of the six most active fractions were evaluated using nano-LC/mass spectrometry. The homology between T. trichiura and the related nematode Trichinella spiralis was used to identify 12 proteins in TtEFs. Among those identified, fructose biphosphate aldolase, a homologue of macrophage migration inhibitory factor and heat-shock protein 70 may contribute to the immunomodulatory effects of TtEFs. The identification of such proteins could lead to the development of novel drugs for the therapy of allergic and other inflammatory diseases.
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Sant'anna CC, Schmidt CM, March MDFBP, Pereira SM, Barreto ML. [Tuberculosis among adolescents in two Brazilian State capitals]. CAD SAUDE PUBLICA 2013; 29:111-6. [PMID: 23370030 DOI: 10.1590/s0102-311x2013000100013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 09/18/2012] [Indexed: 05/27/2023] Open
Abstract
The study analyzed clinical, laboratory, and radiological characteristics of tuberculosis (TB) among adolescents from two Brazilian State capitals, according to the 2010 Updated Guidelines of the National TB Control Program (NTPC) through a descriptive, retrospective cross-sectional study of reported TB cases from Manaus and Salvador from 1996 to 2003. Patients were divided into two groups: 10 to 14 years and 15 to 19 years of age. Variables were studied through descriptive statistics; 1,781 adolescents were included; 928 (52.1%) were males. Median age was 16 years (SD = 2.3). Pulmonary TB (PTB) occurred in 1,447 patients (82.9%), pleural TB in 179 (10.3%), and peripheral adenopathy in 81 (4.6%). Cough was more frequent in the ≥ 15-year PTB group (p < 0.001). Chest x-rays were classified as: adult-type TB in 1,088 (98.6%) in the ≥-15 year group; 258 (98.1%) in the < 15-year group (p < 0.0001). Adult type bacteriological PTB increased in proportion to age.
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Matos SMA, Prado MS, Santos CAST, D'Innocenzo S, Assis AMO, Dourado LS, Oliveira NS, Rodrigues LC, Barreto ML. Validation of a food frequency questionnaire for children and adolescents aged 4 to 11 years living in Salvador, Bahia. NUTR HOSP 2013; 27:1114-9. [PMID: 23165550 DOI: 10.3305/nh.2012.27.4.5883] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 03/27/2012] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia. METHODS The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics. RESULTS The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance. CONCLUSION The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents.
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Mendonça LR, Figueiredo CA, Esquivel R, Fiaccone RL, Pontes-de-Carvalho L, Cooper P, Barreto ML, Alcantara-Neves NM. Seroprevalence and risk factors for Toxocara infection in children from an urban large setting in Northeast Brazil. Acta Trop 2013; 128:90-5. [PMID: 23845771 DOI: 10.1016/j.actatropica.2013.06.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 05/30/2013] [Accepted: 06/28/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to standardize an "in house" immunoassay to detect anti-Toxocara IgG antibodies in human serum to estimate the seroprevalence of Toxocara infection, and to identify its potential risk factors in children living in poor areas of Salvador, a large northeastern Brazilian city. METHODS Parents of 1309 children answered a questionnaire containing possible risk factor for acquisition of this infection. Blood was collected and the presence of anti-Toxocara IgG antibodies was detected by indirect ELISA using T. canis larval excretory-secretory antigens in sera previously absorbed with Ascaris lumbricoides antigens. RESULTS Seroprevalence of Toxocara infection was 48.4%. Children's age, low maternal schooling, contact with dogs and cats, and household located in paved streets were shown to be risk factors for Toxocara infection. CONCLUSIONS The seroprevalence of Toxocara infection is high among children living in a poor urban setting of Brazil. The association of low maternal education with higher Toxocara infection supports studies showing that low socioeconomic status is a risk factor for the acquisition of this infection as a reflection of hygiene habits of the family. And both infected-dogs and cats may be involved in this parasite transmission in this children population.
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Moncayo AL, Vaca M, Oviedo G, Workman LJ, Chico ME, Platts-Mills TAE, Rodrigues LC, Barreto ML, Cooper PJ. Effects of geohelminth infection and age on the associations between allergen-specific IgE, skin test reactivity and wheeze: a case-control study. Clin Exp Allergy 2013; 43:60-72. [PMID: 23278881 PMCID: PMC3563216 DOI: 10.1111/cea.12040] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 08/19/2012] [Accepted: 09/24/2012] [Indexed: 01/15/2023]
Abstract
Background Most childhood asthma in poor populations in Latin America is not associated with aeroallergen sensitization, an observation that could be explained by the attenuation of atopy by chronic helminth infections or effects of age. Objective To explore the effects of geohelminth infections and age on atopy, wheeze, and the association between atopy and wheeze. Methods A case-control study was done in 376 subjects (149 cases and 227 controls) aged 7–19 years living in rural communities in Ecuador. Wheeze cases, identified from a large cross-sectional survey, had recent wheeze and controls were a random sample of those without wheeze. Atopy was measured by the presence of allergen-specific IgE (asIgE) and skin prick test (SPT) responses to house dust mite and cockroach. Geohelminth infections were measured in stools and anti-Ascaris IgE in plasma. Results The fraction of recent wheeze attributable to anti-Ascaris IgE was 45.9%, while those for SPT and asIgE were 10.0% and 10.5% respectively. The association between atopy and wheeze was greater in adolescents than children. Although Anti-Ascaris IgE was strongly associated with wheeze (adj. OR 2.24 (95% CI 1.33–3.78, P = 0.003) and with asIgE (adj. OR 5.34, 95% CI 2.49–11.45, P < 0.001), the association with wheeze was independent of asIgE. There was some evidence that the association between atopy and wheeze was greater in uninfected subjects compared with those with active geohelminth infections. Conclusions and clinical relevance Atopy to house dust mite and cockroach explained few wheeze cases in our study population, while the presence of anti-Ascaris IgE was an important risk factor. Our data provided only limited evidence that active geohelminth infections attenuated the association between atopy and wheeze in endemic areas or that age modified this association. The role of allergic sensitization to Ascaris in the development of wheeze, independent of atopy, requires further investigation.
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Passos JS, Vianna MIP, Gomes-Filho IS, Cruz SS, Barreto ML, Adan L, Rösing CK, Cerqueira EMM, Trindade SC, Coelho JMF. Osteoporosis/osteopenia as an independent factor associated with periodontitis in postmenopausal women: a case-control study. Osteoporos Int 2013; 24:1275-83. [PMID: 23001114 DOI: 10.1007/s00198-012-2130-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 08/01/2012] [Indexed: 12/01/2022]
Abstract
UNLABELLED This study investigated whether osteoporosis/osteopenia has an influence on the progression of periodontitis in postmenopausal women. The findings highlight that postmenopausal women with osteoporosis/osteopenia had a greater chance of presenting periodontitis than those with normal bone mineral density, particularly among nonusers of osteoporosis medications and women with a greater number of remaining teeth, showing that osteoporosis/osteopenia has had an influence on the progression of periodontitis. INTRODUCTION This study investigated whether osteoporosis/osteopenia has an influence on the progression of periodontitis in postmenopausal women and explored the effects of use of osteoporosis medication and tooth loss on this association. METHODS This case-control study involved 521 postmenopausal women, with minimum age of 50 years, in Feira de Santana, Bahia, Brazil. Sociodemographic characteristics, health conditions/medications, and lifestyle habits were recorded. A complete periodontal examination was performed and periodontitis was diagnosed. Bone mineral density was evaluated through lumbar spine and femoral bone densitometry, obtained using dual-energy X-ray absorptiometry. Logistic regression was used to calculate the strength of association between the occurrences of osteoporosis/osteopenia and periodontitis. RESULTS Women with osteoporosis/osteopenia were twice as likely to present periodontitis, as were those with normal bone mineral density, even after adjusting for smoking, age, family income, and last visit to dentist (odds ratios (OR)adjusted=2.24, 95% CI [1.24-4.06], p=0.008). Among nonusers of osteoporosis medication (ORadjusted=2.51, 95% CI [1.33-4.73], p=0.004) and women with at least 10 remaining teeth (ORadjusted=2.50 95% CI [1.18-5.27], p=0.02), the odds ratio was higher and statistically significant. CONCLUSIONS These findings highlight that postmenopausal women with osteoporosis/osteopenia had a greater chance of presenting periodontitis than those with normal bone mineral density, particularly among nonusers of osteoporosis medications and women with a greater number of remaining teeth.
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Teixeira MG, Costa MCN, Souza LPF, Nascimento EMR, Barreto ML, Barbosa N, Carmo EH. Evaluation of Brazil's public health surveillance system within the context of the International Health Regulations (2005). Rev Panam Salud Publica 2013; 32:49-55. [PMID: 22910725 DOI: 10.1590/s1020-49892012000700008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 01/10/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate Brazil's public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). METHODS In 2008-2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). RESULTS Overall, at all three levels of government, Brazil's HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. CONCLUSIONS In general, the core capacities of Brazil's HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels.
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Teixeira MG, Morato V, Barreto FR, Mendes CMC, Barreto ML, Costa MDCN. Risk factors for the incidence of dengue virus infection in preschool children. Trop Med Int Health 2012; 17:1391-5. [DOI: 10.1111/j.1365-3156.2012.03086.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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de Magalhães Simões S, da Cunha SS, Cruz ÁA, Dias KC, Alcântara-Neves NM, Amorim LD, Rodrigues LC, Barreto ML. A community study of factors related to poorly controlled asthma among Brazilian urban children. PLoS One 2012; 7:e37050. [PMID: 22693565 PMCID: PMC3365022 DOI: 10.1371/journal.pone.0037050] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 04/17/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Asthma constitutes a serious public health problem in many regions of the world, including the city of Salvador, State of Bahia-Brazil. The purpose of this study was to analyse the factors associated with poor asthma control. METHODOLOGY/PRINCIPAL FINDINGS Two definitions were used for asthma: 1) wheezing in the last 12 months; 2) wheezing in the last 12 months plus other asthma symptoms or asthma diagnosis ever. The definition of poorly controlled asthma was: at least one reported hospitalisation due to asthma and/or high frequency of symptoms, in the last year. Children with poorly controlled asthma (N = 187/374) were compared with wheezing children with controlled asthma regarding age, gender, atopy, parental asthma, rhinitis, eczema, exposure to second hand tobacco smoke, presence of moulds, pets and pests in the house, helminth infections and body mass index. Crude and logistic regression adjusted odds ratios were used as measures of association. There was a higher proportion of poorly controlled asthma among children with eczema (OR = 1.55; 95% CI 1.02; 2.37). The strength of the association was greater among children with eczema and rhinitis (42.6%, 53.4% and 57.7%, respectively, in children who had no rhinitis nor eczema, had only one of those, and had both (p = 0.02 for trend test). The presence of mould in the houses was inversely associated with poorly controlled asthma (OR = 0.54; 95% CI 0.34; 0.87). CONCLUSIONS/SIGNIFICANCE Our results indicate an association between eczema and poor asthma control in this environment, but emphasize the role of various other individual and environmental factors as determinants of poor control.
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Gomes-Filho IS, Oliveira TJS, Passos JS, Cerqueira EDMM, da Cruz SS, Barreto ML, Coelho JMF, Trindade SC, Santos CAST, Sarmento VA. Effect of osteoporosis on periodontal therapy among post-menopausal women. Gerodontology 2012; 30:40-8. [DOI: 10.1111/j.1741-2358.2012.00643.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Santos DS, Santos DN, Silva RDCR, Hasselmann MH, Barreto ML. Maternal common mental disorders and malnutrition in children: a case-control study. Soc Psychiatry Psychiatr Epidemiol 2011; 46:543-8. [PMID: 20401464 DOI: 10.1007/s00127-010-0220-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Accepted: 03/26/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite improvements in the nutritional status of Brazilian children, child malnutrition remains a public health issue. The objective of the present study was to analyse the effect of maternal common mental disorders (MCMD) on child malnutrition in a large Brazilian urban centre with low rates of child malnutrition. Furthermore, we explored the hypothesis that a reduction in the quality of maternal caregiving mediates the relationship between maternal mental health problems and child nutrition. METHODS A case-control study including 294 children aged between 0 and 5 years, with 147 cases and 147 age- and sex-matched controls, was conducted in the city of Salvador, northeastern Brazil. Mothers completed the Self-Report Questionnaire (SRQ-20), the family's socio-economic status was evaluated and the Home Observation for Measurement of the Environment (HOME) Inventory was applied. Children were diagnosed as moderately or severely malnourished when the weight-for-height z-score was below -2 SD. Conditional logistic regression was used in the analysis, and the final model was created using the backward technique. RESULTS MCMD doubled the risk of moderate or severe malnutrition in children (OR = 2.04; 95% CI: 1.10-3.78). Maternal caregiving can be an important factor mediating the relationship between maternal mental health and child malnutrition. CONCLUSION MCMD must be taken into account in programmes for the treatment and prevention of malnutrition, especially in areas of low malnutrition prevalence.
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Veiga RV, Cunha SS, Dattoli VCC, Cruz ÁC, Cooper PJ, Rodrigues LC, Barreto ML, Alcantara-Neves NM. Chronic virus infections supress atopy but not asthma in a set of children from a large Latin American city: a cross-section study. BMC Pulm Med 2011; 11:24. [PMID: 21569568 PMCID: PMC3125392 DOI: 10.1186/1471-2466-11-24] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 05/14/2011] [Indexed: 12/22/2022] Open
Abstract
Background The prevalence of allergic diseases has increased over recent decades in affluent countries, but remains low in rural populations and some non-affluent countries. An explanation for these trends is that increased exposure to infections may provide protection against the development of allergy. In this work we investigated the association between exposure to viral infections in children living in urban Brazil and the prevalence of atopy and asthma. Methods School age children living in poor neighborhoods in the city of Salvador were studied. Data on asthma symptoms and relevant risk factors were obtained by questionnaire. Skin prick tests (SPTs) were performed to seven aeroallergens, and specific IgE was measured to four of these. Viral infections were determined by the presence of specific IgG in serum to Herpes simplex (HSV), Herpes zoster (HZV), Epstein-Barr (EBV), and Hepatitis A (HAV) viruses. Results A total of 644 (49.7%) children had at least one allergen-specific IgE> 0.35 kU/L and 489 (37.7%) had specific IgE> 0.70 kU/L. A total of 391 (30.2%) children were skin test positive (SPT+), and 295 (22.8%) children were asthmatic. The seroprevalence of viral infections was 88.9% for EBV, 55.4% for HSV, 45.5% for VZV and 17.5% for HAV. Negative associations were observed between SPT+ and HSV (OR = 0.64, CI = 0.51, 0.82) and EBV (OR = 0.63, CI = 0.44, 0.89) infections, but no associations were seen between viral infections and the presence of allergen-specific IgE or asthma. Conclusion These data do not support previous data showing a protective effect of HAV against atopy, but did show inverse associations between SPT+ (but not specific IgE+) and infections with HSV and EBV. These findings suggest that different viral infections may protect against SPT+ in different settings and may indicate an immunoregulatory role of such infections on immediate hypersensitivity responses. The data provide no support for a protective effect of viral infections against asthma in this population.
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Teixeira MG, Costa MDCN, Barreto ML. E o dengue continua desafiando e causando perplexidade. CAD SAUDE PUBLICA 2011; 27:828. [DOI: 10.1590/s0102-311x2011000500001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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D'Innocenzo S, Marchioni DML, Prado MS, Matos SMA, Pereira SRS, Barros AP, Sampaio LR, Assis AMO, Rodrigues LC, Barreto ML. Condições socioeconômicas e padrões alimentares de crianças de 4 a 11 anos: estudo SCAALA - Salvador/ Bahia. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2011. [DOI: 10.1590/s1519-38292011000100005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: identificar os padrões alimentares de crianças e sua associação com o nível socioeconômico das famílias. MÉTODOS: estudo transversal com 1260 crianças de 4 a 11 anos, residentes em Salvador-Bahia que incluiu aplicação de um Questionário de Frequência Alimentar semi-quantitativo. Os padrões alimentares foram identificados, empregando-se análise fatorial por componentes principais. O nível socioeconômico foi avaliado por meio de um indicador socioeconômico composto. Regressão logística multivariada foi empregada. RESULTADOS: identificaram-se quatro padrões que explicaram 45,9% da variabilidade dos dados de frequência alimentar. Crianças que pertencem ao nível socioeconômico mais alto têm 1,60 vezes mais chance (p<0,001) de apresentarem maior frequência de consumo de alimentos do padrão 1 (frutas, verduras, leguminosas, cereais e pescados) e 3,09 vezes mais chance (p<0,001) de apresentarem maior frequência de consumo dos alimentos do padrão 2 (leite/ derivados, catchup/ maionese/ mostarda e frango), quando se compara com aquele de crianças de nível socioeconômico mais baixo. Resultado inverso foi observado no padrão 4 (embutidos, ovos e carnes vermelhas); isto é, quanto maior o nível socioeconômico menor a chance da adoção desse padrão. Tendência similar foi notada para o padrão 3 (frituras, doces, salgadinhos, refrigerante/ suco artificial). CONCLUSÕES: padrões alimentares de crianças são dependentes das condições socioeconômicas das famílias e a adoção de itens alimentares mais saudáveis associa-se aos grupos de mais altos níveis socioeconômicos.
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Figueiredo CA, Alcantara-Neves NM, Amorim LD, Silva NB, Carvalho LCPD, Cooper PJ, Rodrigues LC, Barreto ML. Evidence for a modulatory effect of IL-10 on both Th1 and Th2 cytokine production: the role of the environment. Clin Immunol 2011; 139:57-64. [PMID: 21285005 PMCID: PMC3070800 DOI: 10.1016/j.clim.2010.12.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 12/23/2010] [Accepted: 12/24/2010] [Indexed: 11/25/2022]
Abstract
Allergic and other immune-mediated diseases are complex disease states determined by interplay between host genetics and environmental factors. Environmental changes such as fewer infections and reduced exposure to microbial products have been suggested to have led to insufficient regulation of Th1 and Th2 immune responses, causing an increased incidence of inflammatory diseases. The objective of the present study was to investigate the effect of poor living environmental conditions on mitogen-induced production of cytokines (Th1 and Th2) by peripheral blood leukocytes in children living in urban Brazil and investigate the role of IL-10 in modifying this effect. Our data showed that the proportion of children producing Th1 and Th2 cytokines was lower among those with poor living conditions and that this finding was stronger in children producing IL-10. These results provide a possible biologic explanation for the temporal trends of increasing risk of inflammatory diseases observed in populations living in affluent countries.
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94
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Amorim LDAF, Fiaccone RL, Santos CAST, Santos TND, Moraes LTLPD, Oliveira NF, Barbosa SO, Santos DND, Santos LMD, Matos SMA, Barreto ML. Structural equation modeling in epidemiology. CAD SAUDE PUBLICA 2010; 26:2251-62. [DOI: 10.1590/s0102-311x2010001200004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 06/30/2010] [Indexed: 11/22/2022] Open
Abstract
Structural equation modeling (SEM) is an important statistical tool for evaluating complex relations in several research areas. In epidemiology, the use and discussion of SEM have been limited thus far. This article presents basic principles and concepts in SEM, including an application using epidemiological data analysis from a study on the determinants of cognitive development in young children, considering constructs related to organization of the child's home environment, parenting style, and the child's health status. The relations between the constructs and cognitive development were measured. The results showed a positive association between psychosocial stimulus at home and cognitive development in young children. The article presents the contributions by SEM to epidemiology, highlighting the need for an a priori theoretical model for improving the study of epidemiological questions from a new perspective.
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95
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Silva LK, Blanton RE, Parrado AR, Melo PS, Morato VG, Reis EAG, Dias JP, Castro JM, Vasconcelos PFC, Goddard KAB, Barreto ML, Reis MG, Teixeira MG. Dengue hemorrhagic fever is associated with polymorphisms in JAK1. Eur J Hum Genet 2010; 18:1221-7. [PMID: 20588308 PMCID: PMC2950898 DOI: 10.1038/ejhg.2010.98] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 05/04/2010] [Accepted: 05/07/2010] [Indexed: 01/12/2023] Open
Abstract
To identify genes associated with the clinical presentation of dengue, 50 cases of probable or possible dengue hemorrhagic fever (DHF), 236 dengue fever (DF), and 236 asymptomatic infections were genotyped for 593 single-nucleotide polymorphisms (SNPs) in 56 genes across the type 1 interferon (IFN) response pathway as well as other important candidate genes. By single locus analysis comparing DHF with DF, 11 of the 51 markers with P<0.05 were in the JAK1 gene. Five markers were significantly associated by false discovery rate criteria (q<0.20 when P<6 × 10(-4)). The JAK1 SNPs showed differential distribution by ethnicity and ancestry consistent with epidemiologic observations in the Americas. The association remained significant after controlling for ancestry and income. No association was observed with markers in the gene encoding CD209 (DC-SIGN). An association between DHF and JAK1 polymorphisms is in agreement with expression profiles showing generalized decreased type 1 IFN-stimulated gene expression in these patients.
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96
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Endara P, Vaca M, Chico ME, Erazo S, Oviedo G, Quinzo I, Rodriguez A, Lovato R, Moncayo AL, Barreto ML, Rodrigues LC, Cooper PJ. Long-term periodic anthelmintic treatments are associated with increased allergen skin reactivity. Clin Exp Allergy 2010; 40:1669-77. [PMID: 21039971 PMCID: PMC3034193 DOI: 10.1111/j.1365-2222.2010.03559.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background The low prevalence of allergic disease in the rural tropics has been attributed to the protective effects of chronic helminth infections. There is concern that treatment-based control programmes for these parasites may lead to an increase in the prevalence of allergic diseases. Objective We measured the impact of 15–17 years of anthelmintic treatment with ivermectin on the prevalence of allergen skin test reactivity and allergic symptoms in school-age children. Methods The prevalence of allergen skin test reactivity, exercise-induced bronchospasm and allergic symptoms was compared between school-age children living in communities that had received community-based treatments with ivermectin (for onchocerciasis control) for a period of 15–17 years with those living in geographically adjacent communities that had received no ivermectin. Results The prevalence of allergen skin test reactivity was double in children living in treated communities compared with those in untreated communities (16.7% vs. 8.7%, adjusted OR 2.10, 95% CI 1.50–2.94, P<0.0001), and the effect was mediated partly by a reduced prevalence of Trichuris trichiura among treated children. Ivermectin treatments were associated with an increased prevalence of recent eczema symptoms (adjusted OR 2.24, 95% CI 1.05–4.78, P=0.04) but not symptoms of asthma or rhino-conjunctivitis. The effect on eczema symptoms was not associated with reductions in geohelminth infections. Conclusion Long-term periodic treatments with ivermectin were associated with an increased prevalence of allergen skin test reactivity. There was some evidence that treatment was associated with an increased prevalence of recent eczema symptoms but not those of asthma or rhino-conjunctivitis. Cite this as: P. Endara, M. Vaca, M. E. Chico, S. Erazo, G. Oviedo, I. Quinzo, A. Rodriguez R. Lovato, A.-L. Moncayo, M. L. Barreto, L. C. Rodrigues and P. J. Cooper, Clinical & Experimental Allergy, 2010 (40) 1669–1677.
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97
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Alcântara-Neves NM, Badaró SJ, dos Santos MCA, Pontes-de-Carvalho L, Barreto ML. The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children. Respir Res 2010; 11:114. [PMID: 20731833 PMCID: PMC2939601 DOI: 10.1186/1465-9921-11-114] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 08/23/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The elucidation of factors that trigger the development of transient wheezing in early childhood may be an important step toward understanding the pathogenesis of asthma and other allergic diseases later in life. Transient wheezing has been mainly attributed to viral infections, although sensitisation to aeroallergens and food allergens may occur at an early age. In developing countries, intestinal helminthic infections have also been associated with allergy or atopy-related disorders. OBJECTIVE The aim of this study was to explore the association of Trichuris trichiura and Ascaris lumbricoides infections with wheezing and atopy in early childhood. STUDY DESIGN A cross-sectional study using a Portuguese-language ISAAC phase I questionnaire, adapted for preschool-aged children, nested in a cohort study of childhood diarrhoea, was conducted on 682 children. Two faecal samples per child were examined for the presence of intestinal helminthic infection. IgE antibodies against three allergenic preparations (Dermatophagoides pteronyssinus, Blomia tropicalis and common child food), as well as against A. lumbricoides antigens, were measured in a sub-sample of these children, whose parents allowed the procedure. Atopy was defined by the presence of levels of serum IgE antibodies ≥0.35 kU/L against at least one of the three tested allergenic preparations. RESULTS Active T. trichiura infection but not A. lumbricoides infection was positively associated with wheezing in the total studied children population [adjusted OR = 2.60; CI = 1.54;4.38] and in the atopic children sub-population [adjusted OR = 3.07; CI = 1.00;9.43]. The association with atopy was also positive and statistically significant only in the brute analysis [OR = 2.13; CI = 1.03;4.40]. Anti-A. lumbricoides IgE antibodies, but not current A. lumbricoides infection, were positively associated with wheezing in atopic children [adjusted OR = 2.01; CI = 1.00;4.50] and in non-atopic children [adjusted OR = 3.07; CI = 1.13;8.35] and it was also associated with atopy [adjusted OR = 7.29; CI = 3.90; 13.4]. On the other hands, reports of wheezing were not significantly associated with atopy. CONCLUSIONS These data corroborate previous studies showing that wheezing is predominantly associated with infection in early childhood and shows that anti-A. lumbricoides IgE antibodies, but not active Ascaris infections, are associated with wheezing and atopy. Additionally, the data demonstrate that T. trichiura infection may play a role in the pathogenesis of atopic wheezing in early childhood.
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98
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Fonseca EOL, Teixeira MG, Barreto ML, Carmo EH, Costa MDCN. [Prevalence and factors associated with geohelminth infections in children living in municipalities with low HDI in North and Northeast Brazil]. CAD SAUDE PUBLICA 2010; 26:143-52. [PMID: 20209218 DOI: 10.1590/s0102-311x2010000100015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Accepted: 10/14/2009] [Indexed: 11/22/2022] Open
Abstract
Stool surveys were conducted to estimate the prevalence and identify risk factors for geohelminth infections among children in ten Brazilian municipalities with low human development indices (HDI). Socioeconomic and environmental data were obtained from the children's parents or guardians, and stool samples were examined. The proportion of geohelminth infections according to target variables was calculated. Risk factors were evaluated using multilevel logistic regression. Of the 2,523 children, 36.5% were infected with one or more geohelminths (Ascaris lumbricoides, 25.1%; hookworm, 15.3%; Trichuris trichiura, 12.2%). Overall prevalence of geohelminth infections was 45.7% in rural areas and 32.2% in urban areas. Low family income (OR = 1.75; 1.38-2.23), low maternal schooling (OR = 1.69; 1.39-2.06), presence of garbage near the home (OR = 1.50; 1.22-1.84), and number of individuals in the household (OR = 1.41; 1.17-1.71) were associated with infection. In conclusion, geohelminth infections were closely related to socioeconomic conditions, thus emphasizing the importance of targeted public interventions to improve living conditions as part of sustainable prevention.
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Frota CC, Freitas MV, Foss NT, Lima LN, Rodrigues LC, Barreto ML, Kerr LR. Seropositivity to anti-phenolic glycolipid-I in leprosy cases, contacts and no known contacts of leprosy in an endemic and a non-endemic area in northeast Brazil. Trans R Soc Trop Med Hyg 2010; 104:490-5. [DOI: 10.1016/j.trstmh.2010.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 03/15/2010] [Accepted: 03/15/2010] [Indexed: 11/28/2022] Open
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100
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Krieger N, Alegría M, Almeida-Filho N, Barbosa da Silva J, Barreto ML, Beckfield J, Berkman L, Birn AE, Duncan BB, Franco S, Garcia DA, Gruskin S, James SA, Laurell AC, Schmidt MI, Walters KL. Who, and what, causes health inequities? Reflections on emerging debates from an exploratory Latin American/North American workshop. J Epidemiol Community Health 2010; 64:747-9. [PMID: 20584723 DOI: 10.1136/jech.2009.106906] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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